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Critical Care Research and Practice
Volume 2016, Article ID 5283765, 8 pages
http://dx.doi.org/10.1155/2016/5283765
Research Article

Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study

1Summa Health System, Department of Obstetrics and Gynecology, Akron, OH 44304, USA
2Summa Health System, Department of Medical Education, Virtual Care Medical Simulation Laboratory, Akron, OH 44304, USA
3Biostats Inc., Canton, OH 44730, USA
4Summa Health System, Summa Center for Women’s Health Research, Akron, OH 44304, USA
5Summa Health System, Department of Nursing Professional Development, Akron, OH 44304, USA
6Summa Health System, Department of Obstetrics and Gynecology and Department of Maternal Fetal Medicine, Akron, OH 44304, USA

Received 28 January 2016; Accepted 10 July 2016

Academic Editor: Robert Boots

Copyright © 2016 Jacquelyn Adams et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT) and confidence surveys (CS) were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations. Results. Significant differences were noted in individual KT scores (pre: versus post: , ) and CS total scores (pre: versus post: , ). Significant differences were noted in airway management, ; appropriate cycles of drug/shock-CPR, ; left uterine displacement, ; and identifying causes of cardiac arrest, . Nonsignificant differences were noted for administration of appropriate drugs/doses, ; chest compressions, ; bag-mask ventilation before intubation, ; and return of spontaneous circulation identification, . Groups remained noncompetent in team leader tasks and considering therapeutic hypothermia. Conclusion. This study demonstrated improved OBGYN resident knowledge, confidence, and competence in the management of third trimester maternal cardiac arrest. Several skills, however, will likely require more longitudinal curricular exposure and training to develop and maintain proficiency.